As Reported by the Senate Health, Human Services and Aging Committee

124th General Assembly
Regular Session
2001-2002
Sub. S. B. No. 121


SENATORS Blessing, Fingerhut, Hagan



A BILL
To amend sections 3701.23 and 3701.501 of the Revised1
Code to revise the law regarding required screening2
of newborn children for genetic, endocrine, and3
metabolic disorders.4


BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:

       Section 1.  That sections 3701.23 and 3701.501 of the Revised5
Code be amended to read as follows:6

       Sec. 3701.23.  (A) The director of health shall have charge7
of the laboratory authorized by section 3701.22 of the Revised8
Code. The director may employ an assistant for the laboratory who9
shall be a person skilled in chemistry and bacteriology, and10
receive such compensation as the director may allow. All expenses11
of such laboratory shall be paid from appropriations made for the12
department of health.13

       (B)(1) The public health council, in accordance with Chapter14
119. of the Revised Code, shall adopt, and may amend or rescind,15
rules establishing reasonable fees to be charged for services that16
the laboratory performs. The council need not prescribe fees to17
be charged in any case where the council believes that the18
charging of fees would significantly and adversely affect the19
public health. Except as provided in division (B)(2) of this20
section, allAll fees collected for services that the laboratory21
performs shall be deposited into the state treasury to the credit22
of the "laboratory handling fee fund," which is hereby created for23
the purpose of defraying expenses of operating the laboratory.24

       (2) The council, in accordance with division (B)(1) of this25
section, shall adopt a rule establishing a fee of not less than26
fourteen dollars for tests of newborn children conducted under27
section 3701.501 of the Revised Code. Of each such fee collected28
on or after the rule's effective date, not less than ten dollars29
and twenty-five cents shall be deposited into the state treasury30
to the credit of the genetics services fund, which is hereby31
created, and not less than three dollars and seventy-five cents32
shall be deposited into the state treasury to the credit of the33
sickle cell fund, which is hereby created. Not less than three34
dollars from each fee credited to the genetics services fund shall35
be used to defray costs of phenylketonuria programs. Not less36
than seven dollars and twenty-five cents of each fee credited to37
the genetics services fund shall be used to defray the costs of38
the programs authorized by section 3701.502 of the Revised Code.39
Money credited to the sickle cell fund shall be used to defray40
costs of programs authorized by section 3701.131 of the Revised41
Code.42

       Sec. 3701.501.  (A) The public health council shall adopt43
rules in accordance with Chapter 119. of the Revised Code for44
testing of(1) Except as provided in division (A)(2) of this45
section, all newborn children shall be screened for the presence46
of phenylketonuria, homocystinuria, galactosemia, and47
hypothyroidism. The person designated in the rules shall cause a48
child to be tested in accordance with the rules. The rules may49
require tests for otherthe genetic, endocrine, orand metabolic50
disorders if the following conditions are met:51

       (1) A determination is made by the public health council52
that the disorders cause disability if undiagnosed and untreated53
and are treatable.54

       (2) No additional blood samples or specimens are required to55
conduct the test.56

       All tests required by this section or by rules adopted by the57
public health council pursuant to this section shall be performed58
by the laboratory authorized by section 3701.22 of the Revised59
Code except that if the rules adopted by the public health council60
under this section provide that retesting of children with61
abnormal test results may be performed by laboratories other than62
that laboratory, retests may be performed by any laboratory63
approved by the director of health for that purpose.64

       Rules adopted by the public health council under this section65
shall prescribe a method for giving notice of the proposed tests66
and the results of the tests to the parents of the child. The67
rules shall also prescribe a method for giving notice of the68
proposed tests and the results of the tests to either the person69
who caused the child to be tested, employees designated by the70
rules of the hospital of birth, or the health commissioner for the71
health district where the birth occurred, whichever is appropriate72
as determined by the rules.73

       The rules also shall prescribe laboratory methods and other74
procedures for the detection of such genetic, endocrine, and75
metabolic disorders in newborn children, including procedures for76
retesting and referral of children with abnormal test results.77
With regard to tests for the presence of phenylketonuria, the78
laboratory methods and other procedures prescribed in the rules79
shall include any test that the council determines is effective80
for use in detecting the disorder in children who are less than81
forty-eight hours old.82

       (B)specified in rules, adopted pursuant to this section.83

       (2) Division (A)(1) of this section does not apply if the84
parents of the child object thereto on the grounds that such test85
the screening conflicts with their religious tenets and practices.86

       (B) There is hereby created the newborn screening advisory87
council to advise the director of health regarding the screening88
of newborn children for genetic, endocrine, and metabolic89
disorders. The council shall engage in an ongoing review of the90
newborn screening requirements established under this section and91
shall provide recommendations and reports to the director as the92
director requests and as the council considers necessary. The93
director may assign other duties to the council, as the director94
considers appropriate.95

        The director shall appoint the members of the council. In96
making appointments, the director shall select individuals and97
representatives of entities with interest and expertise in newborn98
screening, including such individuals and entities as health care99
professionals, hospitals, children's hospitals, regional genetic100
centers, regional sickle cell centers, newborn screening101
coordinators, and members of the public.102

        The department of health shall provide meeting space, staff103
services, and other technical assistance required by the council104
in carrying out its duties. Members of the council shall serve105
without compensation, but shall be reimbursed for their actual and106
necessary expenses incurred in attending meetings of the council107
or performing assignments for the council.108

       The council is not subject to sections 101.82 to 101.87 of 109
the Revised Code.110

       (C)(1) The director of health shall adopt rules in111
accordance with Chapter 119. of the Revised Code specifying the112
disorders for which each newborn child must be screened.113

        (2) The newborn screening advisory council shall evaluate114
genetic, metabolic, and endocrine disorders to assist the director115
in determining which disorders should be included in the116
screenings required under this section. In determining whether a117
disorder should be included, the council shall consider all of the118
following:119

        (a) The disorder’s incidence, mortality, and morbidity;120

        (b) Whether the disorder causes disability if diagnosis,121
treatment, and early intervention are delayed;122

        (c) The potential for successful treatment of the disorder;123

        (d) The expected benefits to children and society in124
relation to the risks and costs associated with screening for the125
disorder;126

        (e) Whether a screening for the disorder can be conducted127
without taking an additional blood sample or specimen.128

        (3) Based on the considerations specified in division129
(C)(2) of this section, the council shall make recommendations to130
the director of health for the adoption of rules under division131
(C)(1) of this section. The director shall promptly and132
thoroughly review each recommendation the council submits. If the133
director agrees with a recommendation made by the council, the134
director shall adopt rules that correspond with the135
recommendation.136

        (D) The director shall adopt rules in accordance with137
Chapter 119. of the Revised Code establishing standards and138
procedures for the screenings required by this section. The rules139
shall include standards and procedures for all of the following:140

       (1) Causing rescreenings to be performed when initial141
screenings have abnormal results;142

       (2) Designating the person or persons who will be143
responsible for causing screenings and rescreenings to be144
performed;145

       (3) Giving to the parents of a child notice of the required146
initial screening and the possibility that rescreenings may be147
necessary;148

       (4) Communicating to the parents of a child the results of149
the child's screening and any rescreenings that are performed;150

       (5) Giving notice of the results of an initial screening151
and any rescreenings to the person who caused the child to be152
screened or rescreened, or to another person or government entity153
when the person who caused the child to be screened or rescreened154
cannot be contacted;155

       (6) Referring children who receive abnormal screening or156
rescreening results to providers of follow-up services, including157
the services made available through funds disbursed under division158
(F) of this section.159

       (E)(1) Except as provided in divisions (E)(2) and (3) of160
this section, all newborn screenings required by this section161
shall be performed by the laboratory authorized under section162
3701.22 of the Revised Code.163

        (2) If the director determines that the laboratory164
authorized under section 3701.22 of the Revised Code is unable to165
perform screenings for all of the disorders specified in the rules166
adopted under division (C) of this section, the director shall167
select another laboratory to perform the screenings. The director168
shall select the laboratory by issuing a request for proposals. 169
The director may accept proposals submitted by laboratories 170
located outside this state. At the conclusion of the selection 171
process, the director shall enter into a written contract with the 172
selected laboratory. If the director determines that the 173
laboratory is not complying with the terms of the contract, the 174
director shall immediately terminate the contract and another 175
laboratory shall be selected and contracted with in the same 176
manner.177

        (3) Any rescreening caused to be performed pursuant to this178
section may be performed by the laboratory authorized by section179
3701.22 of the Revised Code or one or more other laboratories180
designated by the director. Any laboratory the director considers181
qualified to perform rescreenings may be designated, including a 182
laboratory located outside this state. If more than one laboratory 183
is designated, the person responsible for causing a rescreening to 184
be performed is also responsible for selecting the laboratory to 185
be used.186

       (F)(1) The director shall adopt rules in accordance with187
Chapter 119. of the Revised Code establishing a fee that shall be188
charged and collected in addition to or in conjunction with any189
laboratory fee that is charged and collected for performing the190
screenings required by this section. The fee, which shall be not191
less than fourteen dollars, shall be disbursed as follows:192

       (a) Not less than ten dollars and twenty-five cents shall be193
deposited in the state treasury to the credit of the genetics194
services fund, which is hereby created. Not less than seven195
dollars and twenty-five cents of each fee credited to the genetics196
services fund shall be used to defray the costs of the programs197
authorized by section 3701.502 of the Revised Code. Not less than198
three dollars from each fee credited to the genetics services fund199
shall be used to defray costs of phenylketonuria programs.200

       (b) Not less than three dollars and seventy-five cents shall201
be deposited into the state treasury to the credit of the sickle202
cell fund, which is hereby created. Money credited to the sickle203
cell fund shall be used to defray costs of programs authorized by204
section 3701.131 of the Revised Code.205

       (2) In adopting rules under division (F)(1) of this section,206
the director shall not establish a fee that differs according to207
whether a screening is performed by the laboratory authorized208
under section 3701.22 of the Revised Code or by another laboratory209
selected by the director pursuant to division (E)(2) of this210
section.211

       Section 2.  That existing sections 3701.23 and 3701.501 of212
the Revised Code are hereby repealed.213